Deinstallation of EMRs

HealthcareITNews.com: “Physician groups in Phoenix are canceling their EMR contracts as a result of training, functionality or affordability issues. This is especially prevalent among smaller physician groups, the report says. ” – Software vendors take note. No matter how “cool” you think your product might be, people won’t use it if it is cumbersome and expensive. Unfortunately, this appears the be the rule in healthcare rather than the exception.

A rose by any other name….

HealthBlog: “Monday evening, I was invited to attend a dinner with my fellow panelists (Dr. David Kibbe, Ravi Sharma, Steve Adams, Martin Pellinat) and others to discuss the idea of clinical groupware.  If you are not familiar with that term, clinical groupware is described as a set of practice management, electronic medical record, decision support, prescription writing and other solutions that could be delivered to clinical practices as services over the Internet.” – Hold the phone. Isn’t that the same thing as SaaS or clound computing or simply and extension of EMR/EHR? Sounds like it to me. Maybe we should all agree on a standard naming convention as different names for the same thing is more confusing than helpful. I’m just sayin’…

Physician’s stolen laptop contains patient information

EMR and HIPPA: “This story made me think of two things:
1. Why is PHI being stored on the laptop in the first place? I wish I could find out if there was an EMR involved. If there was, then the EMR should be storing all of the patient information on the server and none of that data should be stored on the laptop. So, if it gets stolen there’s no breach. That’s the beauty of an EMR these days. There should be no need for this to happen.
2. There’s some really cool technology that’s been coming out in recent laptops that will allow you to remotely wipe out the laptop if it ever gets connected to a network. Basically, once your laptop is stolen you report it stolen and they start tracking it down kind of like they do with stolen cars (same people from what I understand).”
– The story associated with this blog goes on to say that “Patient names, treatment dates, short medical treatment summaries and medical record numbers were stored on the computer.“  This wouldn’t have been an issue if all the patient information was stored in the “cloud” and viewed and updated via a secure connection when necessary. Security aside, data stored on a local hard drive increases the chance for lost or duplicate data. Anyway you slice it, this was a bonehead move.

Not everyone is happy with the idea of ePrescribing

The Angry Pharmacist: Don’t say that your pharmacy associations don’t do anything for you! Now GNP pharmacies get [$%#@] by their own for the low-low cost of only $0.30/eRx.  Here’s something about “quality, safety, and efficiency”: I have seen more errors, decimal point, and unit [$%#@] via SureScript eRx in one week than YEARS OF PAPER PRESCRIPTIONS.  In fact, I keep a file of all of the eRx [$%#@] that I get (it gets about 2-3 a day, that’s 15 a week) so when doctors say how WONDERFUL it is, I show them how many lives I have saved.  I’ve seen injection dose written instead of an oral dose, blatant overdoses, everything you can imagine.  I’ve even had controlled substances faxed to 2 different pharmacies 1 min apart for a cash paying patient MULTIPLE TIMES.  Hows that for safety and quality! …Now here’s the dirty secret of eRx’s …  You see, the “old fashioned way”, doctors had to sign each Rx they gave out to the patient.  However those days are long gone thanks to ePrescribing.  Now all some idiot has to know is the doctors password and ANYONE IN THE OFFICE CAN SEND OFF PRESCRIPTIONS.  That’s right, this bullshit doesn’t save the pharmacies any time, but it saves the doctor a bunch because its pretty much giving anyone who works in the office the power to sign and give patients legit prescriptions (even for controlled substances!)  Before, you had to steal the doctors pad and write out phonies, now anyone in the office with access to the eRx terminal can splatter out narcotics to every pharmacy that takes eRx’s and nobody would be the wiser.” – The author has some pretty interesting things to say about ePrescribing in general. I guess the process isn’t exactly ready for prime time. Take a minute to read the entire article, but only if you don’t have sensitive ears.

Call to slow down EMR development for better security.

HIT Consultant Blog: “The law [HITECH, the law gives incentives to healthcare organizations to digitize personal health information before 2020], which also updates parts of HIPAA, gives the Secretary of Health and Human Services until mid-August to define what constitutes an electronic medical record. In Schmidt’s view initial requirements should start with strong authentication and encryption, and so far, the Secretary has done just that. Citing existing NIST and FIPS standards, HHS guidance includes healthcare data at rest, data in motion, as well as the proper destruction of Protected Health Information. Unfortunately, some health practitioners have begun purchasing e-health systems before the full complement of standards is known.” – No matter how you slice it, security is always going to be a problem. Even now, security is a primary concern for any healthcare facility in the United States. As you expand outside the walls of your existing system it is only going to get worse. I agree that practitioners should slow down and wait until some of this gets worked out. There’s nothing worse than investing in a system that has to be scrapped secondary to jumping the gun.

EMRs as a tool for patient safety.

A short jaunt over to the EMR and HIPPA weblog led me to an interesting article in Time written by Scott Haig, MD. While Dr. Haig touches on a couple of positive features of electronic medical records (EMRs), he like many physicians, focuses on the negatives. He concludes that “Doctors and patients live in a world of painful, pressing questions. The great physicians I’ve known seek answers through personal commitment to each patient and judgment born of practical experience — neither of which I have found in a machine.” I think he is missing the point of an EMR.
Continue reading EMRs as a tool for patient safety.